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Alpine County Health And Human Services Environmental Health 75-B Diamond Valley Road, Markleeville, CA 96120 (530) 694-2146 / (530) 694-2770—Fax Food Facility Permit Application OWNER/OPERATOR Street Home Mailing Nature of FACILITY: Site Mailing Parcel EMERGENCY NOTIFICATION: Contact Phone____________Night Phone_______ Contact #2 Phone____________Night Phone_______ DESCRIPTION: Total Seating Sq. Footage of Establishment__________ Water Owner/Operator’s Signature Date Office Use Only Date Plans Date Plans Amount Plan Review Received food facility permit application Revised: 01/07/2013